Siddhartha, Time, and Lessons from Cancer Patients

Updated: Apr 11

Dear Reader,

I thought it would be a great time to re-visit central philosophies and motivations for pursuing science and medicine in the first place, in an (perhaps foolish) attempt to answer the hardest of questions: “Why?”

Science and medicine together is a physical manifestation of humanity’s will for a better tomorrow. We can objectively create tangible improvements that will make tomorrow better than today, and tomorrow’s tomorrow better than tomorrow. Science has cured many infectious diseases, made our lives much safer, and continues to make inroads for one of the most difficult of challenges: cancer.

But still, one may ask, why do these things make our lives better? If we can live longer, one might argue, we can experience more things, and live life with less pain and suffering. One might ask the question (as many have) if this is merely allowing ourselves the opportunity to live a fuller life, but in itself might not be something that allows our lives to be more fulfilling or happy?

Enter: Siddhartha by Herman Hesse. Originally published in 1922, it is a synthesis of many Indian spiritual traditions communicated through a fictional allegory of Siddhartha’s journey to enlightenment in the time of the Buddha. I was fortunate enough to have read Hesse’s short story (122 pages) back in high school, and at the time I was both deeply moved by the work, and vowed to read it again at some point. Now about 15 years later, I finally came through on that promise I made to myself.

The plot follows the protagonist Siddhartha through what many would consider an unconventional path to enlightenment, by both intent and result. He ostensibly eschews his Brahman status to spend many years as an Ascetic, living without possessions in the forest. Instead of devoting his whole life to this particular pursuit, he opted to move on to discover new things once he felt that he had reached the point of diminishing marginal returns in his spiritual development. His central Way to enlightenment was further solidified after a meeting with the Buddha himself, at the time the only man known to have actually reached nirvana, the ultimate goal of goals among Indian mystics. At the time, the Buddha was gaining many followers, and realized that the Buddha himself had not reached nirvana through any established teaching, that perhaps Siddhartha should not follow any teacher as well. Further, he felt that following any established Way or teacher would potentially be a trap, and that everyone’s path to enlightenment might thus be hidden in plain sight, wrought through a diversity of extraordinary, and more importantly, ordinary experiences.

I do not wish to synopsize the plot further, for others have done this far better than I could. Further, there are simply too many amazing lines from Hesse’s work to choose from, so instead I’d like to attempt to summarize his central thesis:

1) Knowledge can be communicated, but wisdom cannot
2) Wisdom must be learned individually; to become wise, one must become both life’s student, and one’s own teacher
3) In every instance in life is a piece of the wisdom we seek
4) Wisdom, from grand to sublime, is plentiful and everywhere, hidden in plain sight
5) Wisdom is made visible when hearts are vulnerable and minds are open

I adopted much of this central mantra as my own, and in the 15 years since it has been a powerful motivating force in my life and my career. Seen through the lens of Hesse’s thesis: to become enlightened, one must experience many things, take on many challenges, and recognize that the concepts of success and failure are but tempting distractions and states of mind; the real value is derived from the journey, not the destination.

It is part of this mantra that originally informed my decision to pursue my PhD and aim to change medicine for the better in a tangible way. I knew that these were both very, very high bars, that many people with more talent and resources have failed along the way, and that I would be making an immense sacrifice of some of the most productive years of my life. That said, I knew that the tribulations along the way would force me to grow in many ways, and allow me to experience diverse opportunities to catch drops of enlightenment along my journey. Good, bad, or ugly, I vowed to embrace each and every experience in life as an opportunity for learning.

I am very thankful to have walked down this path, and will continue to pursue my personal and professional life through this lens.

Even more broadly: I have come to realize that science is very hard (not a surprise I guess!) and creating new things (drugs, devices, treatment means) to extend patient lives is also incredibly difficult. These things come at the expense of many things, the most valuable of which is our time. Time itself is a bit of a peculiarity; it is both our most valuable resource, and it is ironically a resource that is very difficult to know with certainty how much any individual still has. From this, I have come to embrace the mantra that we must seize at least a little bit of every day for enjoyment and satisfaction, and we should invest our time with more care than we invest anything in life.

I find Hesse’s central thesis very enabling toward that end: allowing a “return” on the investment of our time, regardless of the activity, life situation, and challenges we face, both wrought upon us, and the ones we willingly accept.

Orthogonally is the realization that cancer patients are acutely aware of their mortality and their time, much more so than the general population. To grant an extra year of life to a metastatic cancer patient is to grant a year of life very well-fulfilled. In the evolving phases of my life, I strive to learn from cancer patients, to further seize every day, and keep my heart vulnerable and my mind open for the wisdom we seek.